Abstract
Necrotizing Soft-Tissue Infections (NSTI) are a dreaded form of infections of the layers within the soft tissue compartment (dermis, subcutaneous tissue, superficial fascia, deep fascia, or muscle) that are associated with necrotizing changes and systemic toxicity. These spread rapidly and carry high mortality (16%-24%). These infections can present with trivial features like small ulcers or mild cellulitis. Gram staining is important for empirical treatment and specific treatment starts after culture and sensitivity of the toxic fluid according to the organisms isolated. Even after the advancements of antibiotics, adequate surgical debridement remains the mainstay in limiting the spread of the infection. Novel therapeutic management like hyperbaric oxygen, Intravenous immunoglobulin have been developed but with limited success. Various prognostic scoring systems are present to predict the morbidity and mortality associated with these infections which help to identify high-risk patients who may benefit from the new therapeutic strategies. Care for patients with NSTIs requires an approach with expertise from critical care, surgery, reconstructive surgery, and rehabilitation specialists.
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